Provider Demographics
NPI:1588642623
Name:SEGAL, ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:SEGAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ERIC
Other - Middle Name:A
Other - Last Name:SEGAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:235 SHADY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4380
Mailing Address - Country:US
Mailing Address - Phone:412-362-7795
Mailing Address - Fax:412-362-7723
Practice Address - Street 1:235 SHADY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4380
Practice Address - Country:US
Practice Address - Phone:412-362-7795
Practice Address - Fax:412-362-7723
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003414L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU08239Medicare UPIN
520040Medicare PIN